CEO's shooting lays bare US' health cover woes

NEW YORK: For years, patients in the US healthcare system have grown frustrated with a bureaucracy they don't understand - doctors are included in an insurer's network one year but not the next. Getting someone on the phone to help can be next to impossible. Coverage of care and prescriptions is often unceremoniously denied.
This week's fatal shooting of UnitedHealthcare CEO Brian Thompson has unleashed a wave of public feeling - exasperation, anger, resentment, helplessness - from Americans sharing personal stories of interactions with insurance companies, often seen as faceless corporate giants.
In particular, the words written on ammunition found at the hooting scene - "delay," "deny" and "depose," echoing a phrase used to describe how insurers dodge claim payouts - amplified voices that have long been critical of the industry. "All of a sudden, I am fired up again," said Tim Anderson, describing how his wife, Mary, had to deal with UnitedHealthcare coverage denials before she died from Lou Gehrig's disease, or amyotrophic lateral sclerosis, in 2022. Anderson said they couldn't get coverage for machines to help his wife breathe or talk - toward the end, she communicated by blinking when he showed her pictures. The family had to rely on donations from a local ALS group. "The business model for insurance is don't pay," said Anderson, 67, of Centerville, Ohio.
"When Mary could still talk, she said to me to keep fighting this," he added. "It needs to be exposed."

For Anderson and others, Thompson's death and the message left at the scene have created an opportunity to vent their frustrations. Conversations at dinner tables, office water coolers, social gatherings and on social media have pivoted to the topic, as police efforts to find the gunman keep the case in the news.
University of Pennsylvania researcher Michael Anne Kyle said she's not surprised by the growth of conversation around insurers. "People are often struggling with this by themselves, and when you see someone else talk about it, that may prompt you to join the conversation," she said.

Kyle studies how patients access care and said she's seen frustration with the system build for years. Costs are rising, and insurers are using more controls such as prior authorisations and doctor networks to manage them. Patients are often stuck in the middle of disputes between doctors and insurers. "Patients are already spending a lot of money on healthcare, and then they're still facing problems with the service."
Insurers often note that most of the money they bring in goes back out the door to pay claims, and that they try to corral soaring costs and the overuse of some care.